Obsessive compulsive disorder
Conditions
Interventions
The intervention used is ImRs. ImRs is a technique from schema therapy that 
rewrites images and changes events in a more desirable direction. The aversive 
memories from childhood are rewritten, therefore changing the meaning of the 
original memory or forming an alternative, more competitive memory. ImRs is an 
effective therapeutic technique that is becoming more widely used and 
increasingly researched. A recent meta-analysis shows that ImRs is effective 
for treating negative memories in various mental disorders such as depressive 
disorder, post-traumatic stress disorder, social phobia and also OCS.
Patients in this study will receive a preteratment session and six sessions of 
ImRs (two sessions per week). The affect bridge will be used to select the 
memory that will be worked on with ImRs. A recent situation related to the 
obsessive-compulsive disorder will serve as a gateway to original meaningful 
experiences.
In the first two ImRs sessions, the therapist will rescript the situation. In 
the following sessions, the patient will step into the picture as an adult and 
rescript the situation. If necessary, the therapist can assist or possibly 
rescript himself again (if the patient's capabilities do not allow it). 
In this study, the ImRs is described as a stand-alone intervention, without the 
addition of other treatment methods such as cognitive restructuring.
The therapists conducting the ImRs sessions have already been trained in the 
application of ImRs and will also receive supervision. Also, the ImRs sessions 
will be recorded (audio) and scored using a compliance checklist.
Sponsors
ProPersona (Nijmegen)
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: - Patients have a current DSM-5 diagnosis of obsessive-compulsive disorder as classified with the MINI--S. - The main compulsive symptoms come from the domains of "worry about/anxiety about bacteria and contamination" and "fear of being responsible for calamity/misfortune, injury or misfortune" as measured with the DOCS. - Patients possess imaginary ability. - Patients have a Y-BOCS score of 16 or higher. - Patients have an age between 18 and 64 years. - Patients had previously an adequate CBT for the OCD with insufficiently treatment effect (Y-BOCS 16 or higher).
Exclusion criteria
Exclusion criteria: -Patients are diagnosed with a severe depressive disorder for which they need immediate treatment. -Acute suicidality or high risk of suicide -Patients are diagnosed with a psychosis for which they need immediate treatment. -Intellectual disability (IQ below 70) or severe cognitive function disorders. -Substance abuse or dependance or alcohol abuse or dependence which requires treatment. -Psychofarmacology is changed in the last 8 weeks -Having an additional treatment for the OCD -Inability to fill in questionary due to lack of the Dutch language -Other comorbid psychiatric disorders are not an exclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary objective is to investigate whether ImRs lead to symptom reduction in patients with OCS who have not sufficiently benefited from previous outpatient ERP treatment. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary Objectives: To investigate whether Mastery and believability of core cognitions (related to the memories processed in ImRs) change in a positive way to indicate the possible mechanism of action of ImRs in OCD. In addition, to investigate whether using ImRs leads to change in the areas of dysfunctional schemas, depressive symptoms, quality of life and the emotions guilt, shame, anger, sadness, fear and disgust. It is hypothesized that an increase in Mastery leads to a decrease in OCS symptoms. It is hypothesized that a decrease in the believability of the Core Cognitions leads to a decrease in OCS symptoms. The hypothesis is that the practice of ImRs will lead to a decrease in dysfunctional schemas. The hypothesis is that practicing ImRs will lead to a decrease in depressive symptoms. The hypothesis is that practicing ImRs will lead to an increase in quality of life. It is hypothesized that the practice of ImRs will lead to a decrease in the emotions guilt, shame, anger, sadness, fear, and disgust. | — |
Countries
Netherlands
Outcome results
None listed