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Feeling more confident to encounter negative emotions: The mediating role of distress tolerance on the relationship between self-efficacy and outcomes of exposure and response prevention for OCD.
Xu, Junjia; Falkenstein, Martha J; Kuckertz, Jennie M.
Afiliación
  • Xu J; Obsessive Compulsive Disorder Institute, McLean Hospital, United States of America.
  • Falkenstein MJ; Obsessive Compulsive Disorder Institute, McLean Hospital, United States of America; Harvard Medical School, United States of America.
  • Kuckertz JM; Obsessive Compulsive Disorder Institute, McLean Hospital, United States of America; Harvard Medical School, United States of America. Electronic address: jkuckertz@mclean.harvard.edu.
J Affect Disord ; 353: 19-26, 2024 May 15.
Article en En | MEDLINE | ID: mdl-38423365
ABSTRACT

BACKGROUND:

While exposure and response prevention (ERP) is the first-line treatment for obsessive-compulsive disorder (OCD), up to half of patients do not effectively respond. In an effort to better understand the mechanisms behind ERP, the inhibitory learning model emphasizes the roles of increasing perceived self-efficacy and distress tolerance. While self-efficacy and distress tolerance have separately been shown to predict OCD symptoms and treatment outcomes, no studies have assessed their joint effects in ERP. The current study examined distress tolerance as a mediator of the relationship between self-efficacy and ERP outcomes.

METHODS:

Patients in an intensive ERP-based treatment program (N = 116) completed weekly self-report measures.

RESULTS:

Over the course of treatment, as OCD symptoms reduced, self-efficacy and distress tolerance both significantly increased. Importantly, increases in self-efficacy and distress tolerance mediated each other in explaining symptom reduction, suggesting a possible bi-directional effect.

LIMITATIONS:

The temporal relationship between changes in self-efficacy and distress tolerance is worthy of further investigation. In addition, the current sample had limited racial diversity and might not be representative of patients receiving lower levels of care. Findings merit replication to be ascertained of their reliability.

CONCLUSIONS:

Findings suggest that during ERP, patients gain confidence in their abilities both to cope with general challenges and to withstand distress, potentially helping them engage with exposures and overcome initial fears. These findings provide support for the inhibitory learning model and highlight the mechanistic roles of self-efficacy and distress tolerance in ERP. Clinical implications to target both in treatment are discussed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoeficacia / Trastorno Obsesivo Compulsivo Límite: Humans Idioma: En Revista: J Affect Disord Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoeficacia / Trastorno Obsesivo Compulsivo Límite: Humans Idioma: En Revista: J Affect Disord Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos